Fundamentals Of Nursing 1 Unit One PDF

# Fundamentals of Nursing 1 ## Unit One: The Nurse in the Health Setting By: RNM Siame(Mrs) ### Introduction - Fundamentals of Nursing forms the foundation of nursing and midwifery practice. - It is designed to equip student nurses with knowledge and skills which will assist them practice on the...

# Fundamentals of Nursing 1 ## Unit One: The Nurse in the Health Setting By: RNM Siame(Mrs) ### Introduction - Fundamentals of Nursing forms the foundation of nursing and midwifery practice. - It is designed to equip student nurses with knowledge and skills which will assist them practice on the ward and in the community. - The course also prepares you to be a critical thinker, client advocator, clinical decision maker, and client educator. - It discusses the concepts/ideas and models (theoretical way of understanding an idea) that will guide you in planning the nursing care of the client. - Concepts or ideas taught will assist you understand issues related to illness, wellness, disease, health seeking behavior and health practice. - Introduces you to basic skills that enables you to provide quality nursing care. - Help you understand the importance of providing a safe environment for the patient and what you will do when admitting the patient to the health facility and what kind of nursing care you will provide to terminally ill patients. - In conclusion, the course will further provide you with skills that will enable you to apply First Aid in attending to emergencies. ### General Objective - By the end of this discussion, the Registered Student nurse should be able to understand and explain the role of the nurse in the health care setting and how they collaborate with other health care team members. ### Specific Objectives By the end of this unit, you should be able to; - Define the key terms related to nursing. - Describe Nursing Philosophy - Describe the organization and functions of the hospital and community health services. - Describe the roles of the Nurse - Describe the Nurse and the health care team in the hospital and the community settings. ### The Nurse in the Health Care Setting - This unit forms the foundation of the whole course and all other subsequent units act as building blocks that will finally form a complete whole course. - The learning materials you will come across in this unit will help you to define key terminologies that are used in Fundamentals of Nursing; describe the nursing philosophy and the role of the nurse in the hospital and community setting. - This unit goes on to look at the organisation and functions of the hospital and community health services. - Hence this unit is important for you to pay attention to as it explains your role as a nurse. - The health care system in Zambia generally offers disease prevention, health promotion and primary, secondary and tertiary heath care services in a variety of health care settings. - Nurses/midwives are especially important as client advocates in maintaining continuity of care throughout the levels of care. ### Definition of Terms #### The Nurse - A nurse is an individual who has completed a basic programme of nursing education and is qualified and authorized in his/her country to practice as a nurse (Ngugi, 1984). - In Zambia for one to practice nursing, he/she must be registered with Nursing and Midwifery Council of Zambia (NMCZ). ### Definition #### Nursing The term nursing is derived from a Latain word "Nutricus" which simply means to nature. - Therefore, nursing is an art and science drawn from biological, social as well as behavioural sciences in rendering care individuals, families and the community. - "It is the diagnosis and treatment of human responses to actual or potential health problems" (ANA 1980). #### Midwife - A person who have been admitted to a Midwifery training programme and has successfully completed and acquired skills to be registered to legally practice as a midwife. ### Definitions Cont' #### Nursing - Virginia Henderson defines nursing as "assisting the individual (sick or well) in the performance of those activities contributing to the health or its recovery (or to a peaceful death) that he would perform unaided if he/she had the necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible (Virginia Henderson 1960). ### Definitions... #### Nursing Practice It is any treatment or action based upon clinical judgement and knowledge that nurses perform to enhance patients outcomes which are designed to assist the client in moving from the present level of health to that which is described in the goal and measured by the expected outcome (Potter and Perry, 2005). #### Nursing Practice ... - It is the sharing of responsibility for the health and welfare of all people in the community and participating in programmes designed to prevent illness and maintain health. - It is coordinating and synchronizing medical and other professional and technical services that affect patient care. - It is supervising, teaching and directing all those involved in nursing care. ### Definitions...... #### Fundamentals of Nursing - This is the course that covers the basic principles and practices of nursing which emphasizes the importance of the fundamental needs of humans as well as competence in basic skills as prerequisites to providing comprehensive nursing care. - It is a course that comprehensively covers the nursing concepts, skills and techniques of nursing practice. - It provides a contemporary approach to nursing practice, discusses the entire scope of primary, acute and restorative care. ### Nursing Philosophy - Nursing philosophy is "a vision for how nursing should be practiced. - It is a statement that declares a Nurse's belief, values and ethics regarding their care and treatment of patients while they are in the nursing profession. ### Defitions..... #### Philosophy - A philosophy is a statement of beliefs and values which motivates action in a certain way - The study of the fundamental nature of knowledge, reality, and existence, especially when considered as an academic discipline ### Definitions ... - Philosophy guides behaviour of how to go about with different activities as an individual, family, institution, profession or even a country. - Philosophy is expressed in form of statements of beliefs and values regarding life and reality e.g. the importance of man regardless of ethnicity and colour ### Definitions .... #### Beliefs - These are ideas that one accepts as true, especially one without proof. - They may be expressed by such things as decisions, opinions and creed. ### Definitions... #### Values - These are standards for decision making that endure for a significant time in one's life. - They are abstract ideas that have four (4) basic parts; thinking, choosing, feeling and behaving ### Definitions .... #### Value system - It is an enduring set of principles and rules organized into a hierarchy. - When choosing between alternatives and making decisions, value systems help people decide which values are most important. - Different theories and concepts are used to define and interpret nursing philosophy. ### Definitions .... - The international council of nurses formulated some of these standards. - The fundamental responsibility of the nurse is four fold:- - To conserve life - To alleviate suffering - To promote health - To prevent disease and disability ### The philosophy for the training nursing schools - The members of staff for registered nursing schools believe that all nursing activities are centred around man. - This simply means nursing should be directed towards meeting man's needs. - We believe that nursing is an art and science which draws from biological, social and behavioural sciences in rendering of care to individuals, families and communities. - We believe that the registered nurse should use the nursing process as a tool for nursing practice. - We believe that the program to train registered nurses should be oriented towards meeting comprehensive needs of all people regardless of age, colour, race, creed or social status. - We believe that public health care is a strategy to provide care to all. - We believe that the program should emphasize the role of a registered nurse optimally in the health care services of the Zambian community. - We also believe that the fundamental responsibility of the nurse is to promote health, educate the individual, families and community to prevent disease and disability in order to restore health and alleviate suffering. - We believe that despite the shortage of manpower, essential facilities and equipment, social and cultural factors, nurses should continue to improve and render effective nursing care to individual families and communities in meeting their needs. - We believe that learning is an active and continuous process and that teaching should be learner oriented. - Finally, we believe that registered nurse curriculum forms the basis of professional nursing and the student of this program should assume responsibilities for his or her personal and professional development and that he or she should be guided by the staff towards the attainment of this goal. ### Organization and functions of the Hospital and Community Health Services #### Hospital - This is an institution whose main function is to care for the sick and injured people. - It is composed of patients, nursing staff, doctors and the members of the health team. #### The Patient - A person who is undergoing treatment or is ill. ### CONT' #### Client - An individual registered with the medical institution and seeking assistance from the hospital whether ill or not. #### Health care team - It is a group of health care providers who work together for the benefit of the patient e.g. Doctors, nurses, cleaners etc. - The Centre of the team is the patient and his ### CONT' #### Role of the hospital is to; - Diagnose disease or injury quickly and accurately. - Curing disease or injury with minimal discomfort, cost and residual disability. - Alleviating suffering when cure is not possible; and helping those with terminal illness to die peacefully and with dignity. - To carry out research. - Promoting positive health. ### Departments in the hospital - The hospital has various departments which carry out varying functions such as: - **Administration**: This is the Governing body of the hospital. - It is like the school administration, So for the hospital, all the heads of departments make up what is called administration. ### CONT' - **Accounts Department**: This handles financial transactions for the hospital, patients and hospital workers. ### CONT' - **Radiology**: This is a medical specialty that uses medical imaging to diagnose and treat diseases within the body. It does radiological investigations such as X-rays, ultra sound scan, MRI, etc. - **Laboratory**: This is a diagnostic department of the hospital which does various investigations such as hematology (blood tests), parasitology (stool, urine and blood tests), bacteriology and virology. ### CONT' - **The Chaplaincy department**: This department provides spiritual care to patients and personnel. - **Catering Department**: This department is responsible for the preparation of appropriate and prescribed meals for patients ### CONT' - **Housekeeping**: This is a department that is responsible for the general cleanliness of the hospital. - **Maintenance Department**: This is a department that is responsible for maintenance of hospital equipment and buildings. ### CONT' - **Laundry Department**: This is a department that is responsible for washing and repairing of hospital linen and ensures that wards have adequate supplies. ### CONT' - **Pharmacy Department**: This is the department responsible for ordering, preparation and dispense of prescribed drugs and medical supplies to patient/clients/wards. ### CONT' - **Purchasing and Stores Department**: This is a department that is responsible for buying hospital requirements such as food, medicines, stationery etc. - It also ensures that the hospital has adequate stocks all the time. ### CONT' - **Medical Records Department**: This is the department which takes care of all patients' records and other official essential hospital records. ### CONT' - **Central Sterile Supply Department (CSSD)**: This department is responsible for sterilizing and distribution of sterile supplies and equipment to the wards and operating rooms (theatres). ### CONT' - **Physiotherapy Department**: This department treats patients by means of physical agents such as heat, water or exercises. - For example people who have broken their limbs may need to be assisted in learning how to walk again ### CONT' - **Social Services Department**: This is the department that attends to patients that require social aid. - **Intensive Care Unit (ICU)**: It is a unit in the third level hospitals that cares for critically ill patients who require critical support. ### The Role of the Nurse - The nurse wears a lot of names depending on what function one is performing. - This is why as you have joined this noble profession, your image is mirrored by the public in the images are as follows: ### The role of the nurse ... #### Care Giver - He/She helps client regain health through the healing process by meeting all health care needs of the client such as measures to restore physical, emotional, spiritual and social well-being. - She provides individualised nursing care for specific clients and their families. ### The role of the nurse ... #### Decision Marker - Nurse uses decision making skills throughout the nursing process depending on her/his assessment of patients' needs or problems. ### The role of the nurse ... #### Client Advocate - The nurse speaks for the patients and other vulnerable groups. The nurse also assists the clients and their families to interpret information from other care providers - Protects client's human and legal rights and provide assistance in asserting those rights if need arises, (Potter and Perry, 2009) ### The role of the nurse ... #### Educator - Explains to clients' concepts and facts about health, demonstrates procedures e.g. self-care activities, determines that client fully understands, reinforces learning or client's behaviour and evaluates progress in learning. ### The role of the nurse ... #### Manager - As managers, nurses coordinate and delegate care responsibilities and supervise other health care workers in delivering quality nursing care. ### The role of the nurse ... #### Communicator - Communication is important to the nurse - client relationship. - Therefore, Nursing involves communication with clients and families to identify their strengths and weaknesses, their needs and their fears. ### The role of the nurse ... - With communication, it is possible for the nurse to give care, comfort and emotional support. ### The role of the nurse ... #### Rehabilitator - Nurses help clients cope with life style changes associated with chronic illness or physical impairment. - For example a nurse can assist in teaching the client on how to use physical devices such as clutches. ### The role of the nurse ... #### Counsellor - In counselling, the nurse helps clients identify and clarify health problems and help them choose appropriate courses of action to solve their problem. ### The role of the nurse ... - As a counsellor, the nurse is responsible for providing information, listening objectively, being supportive, caring and trustworthy. - She/he does not make decisions but helps client reach decisions that are best for them. ### The role of the nurse ... #### Collaborator - As a collaborator, the nurse works in a combined effort with all those involved in care delivery in seeing to it that mutually acceptable plans are achieved to meet the common goals. ### The role of the nurse ... #### Epidemiologist - The nurse is involved in case finding, health teaching and tracking incident rates of an illness. - For example the nurse follows up a case of tuberculosis in the community. ### The role of the nurse ... #### Change agent - As a change agent, the nurse is involved in identifying and implementing new and more effective approaches to problems. - She/he empowers individuals and their families to creatively solve problems or become instrumental in creating change within a health institution. ### The role of the nurse ... #### Consultant - The nurse can provide expert advice to other health care providers as well as clients and their families ### The Nurse and health care team in the hospital and the community setting #### The Nurse and health care team in the hospital - **Health care team**: is a group of health care providers who work together for the benefit of the patient e.g. Doctors, nurses, physiotherapists, nutritionist, radiographers etc. - The Centre of the team is the patient and his family. ### The nurse and health care team in the hospital ... - Therefore, the Nurse does not work in isolation. - There are other members who are not nurses who contribute to the effective management of the clients. ### The nurse and health care team in the hospital ... - The members of the multi -disciplinary team in the hospital set up include the following: - **Medical doctors**: These are responsible for screening the patients, prescribing drugs and carrying out both medical and surgical procedures ### The nurse and health care team in the hospital ... - **Laboratory Technician**: They examine specimens in order to come up with the right diagnosis. ### The nurse and health care team in the hospital ... - **Physiotherapists**: They treat patients by means of physical agents such as heat, water or exercises. - For example people who have broken their limbs may need to be assisted in learning how to walk again. ### The nurse and health care team in the hospital ... - **Nutritionists**: They provide information about diet. Nutritionists can also prescribe diet which may be therapeutic e.g. diabetic diet - **Radiographer**: These take and develop x rays for diagnostic purposes ### The nurse and health care team in the hospital ... - **Social worker**: They usually talk to patients and identify those in need with the help of the other hospital. - The social worker also looks at the economic status and the general welfare of the patient. Some social workers also provide counselling ### The nurse and health care team in the hospital ... - **Pharmacist**: The pharmacist prepares and dispenses drugs. - They provide advice to about drugs to clients and other members of the multi- disciplinary team - **Occupational therapists**: They educate patients on different skills in order to rehabilitate them after injury or illness - **Speech therapists**: They help in rehabilitating patients who have problems with speech after an illness ### CONT, - **Chaplain**: The chaplain provides spiritual care and support to clients. - The chaplain may also provide counseling for both spiritual and social issues - The members of the multi -disciplinary team interact at different levels in the provision of medical treatment. ### CONT, - Without meaningful interaction, provision of health care will be compromised. - Each health care team member should recognize and treat each other with respect. ### The Nurse in the community setting - Nursing in community based setting is concerned primarily with health promotion and maintenance, education and management, coordination and continuity of care within the community. ### CONT' - Community – based nurses assess the health needs of individuals, families and communities and help clients cope with threats to health and problems of illness. - They provide services for acute and chronic conditions to individuals and families within the community. ### CONT' - Community – based nurses are employed in a variety of settings such as in schools, industries, nursing homes and private practices. ### UNIT SUMMARY - In Unit one, we looked at the definition of the terminologies: Nurse, nursing, nursing practice and fundamentals of nursing and nursing philosophy. - The unit introduced you to the hospital organization showing the different departments of nursing and community health services. ### Unit summary ... - It must be interesting that you now know your role as a nurse and how your role blends with the other members of the health team in service delivery. - This unit has informed you that you require the help of other trained hospital staff to enable you render the care required by the patient. ### THE END!!! 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